Provider Demographics
NPI:1033403266
Name:BLUE SKY, MD PC
Entity Type:Organization
Organization Name:BLUE SKY, MD PC
Other - Org Name:BLUE SKY MD OF THE CAROLINAS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BILLING DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:RUTH
Authorized Official - Middle Name:E
Authorized Official - Last Name:MARTIKAINEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:828-586-8160
Mailing Address - Street 1:PO BOX 360
Mailing Address - Street 2:
Mailing Address - City:SYLVA
Mailing Address - State:NC
Mailing Address - Zip Code:28779-0360
Mailing Address - Country:US
Mailing Address - Phone:828-587-6312
Mailing Address - Fax:828-586-8209
Practice Address - Street 1:317 N KING ST STE A
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28792-4349
Practice Address - Country:US
Practice Address - Phone:828-693-9199
Practice Address - Fax:828-692-2487
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RESULTSPA, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-06-06
Last Update Date:2013-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200400137261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCI06634Medicare UPIN